Pandemic babies’ developmental milestones: Not as bad as we feared, but not as good as before


The COVID-19 pandemic created conditions that threatened children’s healthy development.

Scientists and physicians raised concerns early in the pandemic, pointing out that increased parental stress, COVID infections, reduced interactions with other babies and adults and changes to health care could affect child development. Furthermore, some children could be especially vulnerable to the pandemic circumstances.

With these concerns in mind, we started a longitudinal study of pregnant Canadians to understand how pandemic stressors might influence later child development.

Our initial findings were alarming: the rates of anxiety and depression among pregnant individuals were two to four times higher during the early phase of the pandemic compared to numerous pregnancy studies prior to the pandemic. This worrisome increase in mental health problems was seen worldwide.

Impact on children’s development

To determine how the pandemic might be affecting children’s development, we measured developmental milestones in 3,742 12-month-old infants born during the first 18 months of the pandemic. We then compared these infants to a similar group of 2,898 Canadian infants born between 2015 and 2018.

A pregnant woman and a doctor both wearing face masks in the doctor's office
Rates of anxiety and depression among pregnant individuals were two to four times higher during the early phase of the pandemic compared to numerous pregnancy studies prior to the pandemic.
(Shutterstock)

The study evaluated developmental milestones using the Ages and Stages Questionnaire-3. The ASQ-3 is a parent report of child behaviour that can help identify children at risk of developmental delays in five separate domains: Communication, Gross Motor, Fine Motor, Personal-Social and Problem Solving.

In a study to be published in the Journal of Developmental and Behavioral Pediatrics, we found that most children born during the pandemic were doing fine, with almost 90 per cent meeting their key developmental milestones in each area. This should be reassuring for parents, caregivers and communities, because it suggests that most children are developing normally despite adverse early circumstances.

However, a slightly higher proportion of children born during the pandemic were at risk of developmental delay in Communication, Gross Motor and Personal-Social domains, compared to children born before the pandemic. Our findings are consistent with prior smaller studies showing only small increases in the risk for poor verbal, motor and cognitive performance among 12-month-old infants born during the pandemic.

A woman smiling and playing with her baby in her lap
Engaging an infant in conversation or song (even a pre-verbal infant) is a powerful way to encourage language learning.
(Shutterstock)

The largest effects we observed were in the Communication and Personal-Social domains. Infants born during the pandemic were almost twice as likely to score below cutoffs compared to pre-pandemic infants.

This represents an increase of about one to two additional children in 100 who are at risk, but highlights some potentially concerning effects of the pandemic on early child development. Across Canada, this could result in service demands for 20,000-40,000 additional preschool children.

Although small in absolute terms, these increases have important implications, since already limited resources will need to increase to meet the needs of more children. Certainly, it will be important to continue monitoring infants/children born during the pandemic to determine how long-lasting these effects are.

Reassuringly, early interventions can be highly effective for children who are struggling.

Concerns about child development

A smiling baby crawling towards the camera in the foreground, and a young man smiling in the background
Provide your child with many opportunities for one-on-one interaction with a caring and responsive adult.
(Shutterstock)

Parents should be mostly reassured by these findings. Despite the disruptions to nearly every aspect of life during the pandemic, the majority of children continue to show healthy development. Parents with concerns about their child’s development may find these suggestions helpful:

  1. Provide your child with many opportunities for one-on-one interaction with a caring and responsive adult. The Harvard Center on the Developing Child describes the back-and-forth interactions that form the key processes of child development as “serve and return.”

  2. Believe in “ordinary magic.” This is the phrase that child development expert Ann Masten uses to describe how resilience emerges from ordinary, everyday processes and interactions. Children develop resilience when they have access to the right environments, the right relationships and the right chances to be able to safely explore themselves and the world around them.

  3. Talk and sing with your child. Engaging an infant in conversation or song (even a pre-verbal infant) is a powerful way to encourage language learning.

  4. There is a wide range of development that is considered “normal.” It is okay for your child to be at a different stage than other children their age, as long as your child is still showing signs of development.

  5. If you are concerned about your child’s development after some time of monitoring, discuss your concerns with a qualified health professional to determine if further investigation is needed.

Overall, the findings of our study (and others) suggest that the effects of the pandemic on infant development (at least to one year of age) have not been as bad as we feared. However, a greater number of children will likely require further evaluation and support compared to pre-pandemic.



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